DYSRHYTHMIA BASIC A COMPETENCY EXAM
2026 PRACTICE QUESTIONS AND ANSWERS
◉ Second degree AV block Type I. Answer: progressive prolongation
of PRI, gradual shortening of R to R intervals
P wave not followed by a QRS wave
a pause with an R to R interval less than the sum of two P to P
intervals
first conducted atrial impulse after the pause shows a shorter or
normal PRI
◉ Second Degree AV Block Type 2. Answer: Rhythm: ventricular
irregular; atrial regular
Rate: atrial rate > ventricular rate
P waves: P waves may not be followed by QRS
PRI: WNL or prolonged ; PRI before and after a blocked P waves are
constant.
QRS duration: WNL; greater than 0.11 sec block occurs below the
bundle.
,◉ characteristics of first degree AV block. Answer: rhythm: regular
Rate: usually WNL
P waves: one positive before each QRS complex
PRI: prolonged
QRS: normal
◉ causes of first degree AV block. Answer: - normal in hx of cardiac
disease especially athletes
- Acute MI
- acute mydocarditis or endocarditis
- cardiomyopathy
- degenerative fibrosis and sclarosis
- drugs
- hyperkalemia
- increased vagal tone
- ischemia or injury to the AV node or AV bundle
- rheumatic heart disease
- valvular heart disease
◉ what causes second degree AV block type I. Answer: RCA, athletes,
aortic valve disease, atrial septal defects, meds, mitral valve
prolapse, rheumatic heart disease.
,◉ what do i do about second degree AV block type I. Answer:
atropine for bradycardia.
◉ second degree AV block type II causes. Answer: MI is related to
conduction effects, acute myocarditis, aortic valve disease,
cardiomyopathy, fibrosis of the conduction system, rheumatic heart
disease
◉ second degree AV block type II s/s. Answer: depends on the
ventricular rate: if normal it is asymptomatic. could progress to third
degree, pacemakers, ECG, pulse ox, obtain VS, administed oxygen, est
IV access
temporary or permanent pacing
◉ third degree heart block. Answer: Rhythm: ventricular regular;
atrial regular, no relationship is present
Rate: the atrial rate is greater than the ventricular and the
ventricular rate is determined by the escape
P waves: normal in size and shape; not followed by a QRS complex
, PRI: no PRI bc they are not related
QRS: narrow or wide depending on the location of the pacemaker
◉ hypokalemia T waves. Answer: depressed T waves
◉ hyperkalemia T waves. Answer: elevated T waves
◉ causes of third degree heart block. Answer: acute MI
acute myocarditis
congenital heart disease
drug effect
fibrosis of the conduction system
increased parasympathetic tone
◉ capture. Answer: The successful conduction of an artificial
pacemaker's impulse through the myocardium, resulting in
depolarization
◉ demand pacemaker. Answer: Pacemaker that discharges only
when the patient's heart rate drops below the preset rate for the
pacemaker; also known as a synchronous or noncompetitive
pacemaker.
2026 PRACTICE QUESTIONS AND ANSWERS
◉ Second degree AV block Type I. Answer: progressive prolongation
of PRI, gradual shortening of R to R intervals
P wave not followed by a QRS wave
a pause with an R to R interval less than the sum of two P to P
intervals
first conducted atrial impulse after the pause shows a shorter or
normal PRI
◉ Second Degree AV Block Type 2. Answer: Rhythm: ventricular
irregular; atrial regular
Rate: atrial rate > ventricular rate
P waves: P waves may not be followed by QRS
PRI: WNL or prolonged ; PRI before and after a blocked P waves are
constant.
QRS duration: WNL; greater than 0.11 sec block occurs below the
bundle.
,◉ characteristics of first degree AV block. Answer: rhythm: regular
Rate: usually WNL
P waves: one positive before each QRS complex
PRI: prolonged
QRS: normal
◉ causes of first degree AV block. Answer: - normal in hx of cardiac
disease especially athletes
- Acute MI
- acute mydocarditis or endocarditis
- cardiomyopathy
- degenerative fibrosis and sclarosis
- drugs
- hyperkalemia
- increased vagal tone
- ischemia or injury to the AV node or AV bundle
- rheumatic heart disease
- valvular heart disease
◉ what causes second degree AV block type I. Answer: RCA, athletes,
aortic valve disease, atrial septal defects, meds, mitral valve
prolapse, rheumatic heart disease.
,◉ what do i do about second degree AV block type I. Answer:
atropine for bradycardia.
◉ second degree AV block type II causes. Answer: MI is related to
conduction effects, acute myocarditis, aortic valve disease,
cardiomyopathy, fibrosis of the conduction system, rheumatic heart
disease
◉ second degree AV block type II s/s. Answer: depends on the
ventricular rate: if normal it is asymptomatic. could progress to third
degree, pacemakers, ECG, pulse ox, obtain VS, administed oxygen, est
IV access
temporary or permanent pacing
◉ third degree heart block. Answer: Rhythm: ventricular regular;
atrial regular, no relationship is present
Rate: the atrial rate is greater than the ventricular and the
ventricular rate is determined by the escape
P waves: normal in size and shape; not followed by a QRS complex
, PRI: no PRI bc they are not related
QRS: narrow or wide depending on the location of the pacemaker
◉ hypokalemia T waves. Answer: depressed T waves
◉ hyperkalemia T waves. Answer: elevated T waves
◉ causes of third degree heart block. Answer: acute MI
acute myocarditis
congenital heart disease
drug effect
fibrosis of the conduction system
increased parasympathetic tone
◉ capture. Answer: The successful conduction of an artificial
pacemaker's impulse through the myocardium, resulting in
depolarization
◉ demand pacemaker. Answer: Pacemaker that discharges only
when the patient's heart rate drops below the preset rate for the
pacemaker; also known as a synchronous or noncompetitive
pacemaker.
